Aggressive anticancer treatment in the last 2 weeks of life

Golob, Nena (author), Oblak, Teja (author), Čavka, Luka (author), Kušar, Maša (author), Šeruga, Boštjan (author)

Background: There is a concern that terminally ill cancer patients may be aggressively treated due to the rapidly growing possibilities of anticancer treatment. The aim of this study was to evaluate the use of anticancer treatment at the end of life (EoL). Materials and methods: This retrospective study included adult patients with advanced solid cancers who were treated at the Institute of Oncology Ljubljana and died of cancer between January 2015 and December 2019. A multiple logistic regression model was used to assess an association between the aggressiveness of anticancer treatment (i.e. systemic therapy, radiotherapy and surgery) in the last 2 weeks of life and year of death, age at death, sex, prognosis of cancer and enrolment into the specialist palliative care (SPC). Results: We included 1736 patients in our analysis. Overall, 13.7% of patients were enrolled into the SPC and 14.4% received anticancer treatment in the last 2 weeks of life. The odds of receiving anticancer treatment significantly increased over time [odds ratio (OR) 1.15, 95% confidence interval (CI) 1.04-1.27]. There was an increased use of novel systemic therapy (e.g. small-molecule targeted therapy and immunotherapy) at the EoL. Older patients had significantly lower odds to receive anticancer treatment in the last 2 weeks of life as compared to younger patients (OR 0.96, 95% CI 0.95-0.98). As compared to patients receiving only a standard oncology care, those also enrolled into the SPC had significantly lower odds for anticancer treatment in the last 2 weeks of life (OR 0.22, 95% CI 0.12-0.43). Conclusions: Terminally ill cancer patients have increased odds for receiving anticancer treatment, especially novel systemic therapies, in the last 2 weeks of life. Younger patients and those not enrolled into the SPC are at particular risk for anticancer treatment at the EoL.

• Language: English
• Keywords: systemic therapy, aggressive treatment, anticancer drugs, palliative care, anticancer treatment, specialist palliative care, end of life
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: 8 str.
• Numbering: Vol. 9, iss. 3, art. 102937
• PID: 20.500.12556/RUL-164443
• UDC: 616-006
• ISSN on article: 2059-7029
• DOI: 10.1016/j.esmoop.2024.102937
• COBISS.SI-ID: 189297923
• Publication date in RUL: 25.10.2024

Record is a part of a journal

• Title: ESMO open
• Shortened title: ESMO open
• Publisher: Elsevier, European Society for Medical Oncology
• ISSN: 2059-7029
• COBISS.SI-ID: 3924453

Licences

• License: CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
• Link: http://creativecommons.org/licenses/by-nc-nd/4.0/
• Description: The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.

Secondary language

• Language: Slovenian
• Keywords: sistemsko zdravljenje, onkološka zdravila, agresivno zdravljenje, paliativna oskrba

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: P3-0321
• Name: Napovedni dejavniki poteka bolezni in odgovora na zdravljenje pri različnih vrstah raka

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: P3-0154
• Name: Metodologija za analizo podatkov v medicini